All About Me Home Enrollment Information All About Me Child InformationName Date of Birth SiblingsSiblings Name Age Add RemovePetsPets I have a: It's name is: Add RemovePlayPrevious group experience: DaycarePlaygroupOtherPlease describe Playmates are usually: GirlsBoysOlderYoungerHow does your child get along with other children: EMOTIONAL AND PERSONALITY DEVELOPMENTIs your child affectionate? YesNoDoes your child accept new people easily? YesNoTypical reaction to new people: Does your child have specific fears: Does your child separate easily from you? YesNoWays we can help with this: How does your child react to change? INFANT(Duckling Room Only)Does your infant: Use a pacifierSuck thumb/fingerIs your infant: Breast FedBottle Fed w/ Breast MilkBottle Fed w/ FormulaHow often and how many ounces at each feeding? Has your infant had any feeding issues? YesNoIf yes, explain: Solid FoodsHas your infant started solid food? YesNoHave you noticed any allergies or sensitivities to particular foods? YesNoIf yes, explain: What solids has your infant tried? SleepDoes your infant: Sleep in a crib/bassinetCo-SleepWhat techniques do you use to get your infant asleep? INFANT AND TODDLER(Duckling & Chipmunk Rooms Only)Does your child have a fussy time? YesNoWhen & the best way to handle fussy time: SleepSleeping habits during the day: How often does your infant/toddler nap and for how long? TODDLERToilet TrainingHas toilet training been attempted? YesNoIf yes, is child dry: OccasionallyAll dayWhile sleepingFully trained Day/NightWhat strategies are used at home while training? Does your child wear: DiaperPull upsUnderwearDoes your child struggle going to the bathroom away from home? YesNoIf yes, explain: OTHER INFORMATIONPlease list some of your child's favorites!Food: Game: Song: Activity: Color: Animal: Toy: Book: Please use this space to share anything you would like us to know about your child: EmailSubmit